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Polymicrobial Purulent Pericarditis From a Pancreatico-Pericardial Fistula

Christopher Richardson1, Mark Cromer2, Luis Tatem1

  • 1Division of Pulmonary, Allergy, & Critical Care Medicine, School of Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA.

JACC. Case Reports
|March 11, 2024
PubMed

Insights

A rare case of purulent pericarditis caused by a pancreatico-pericardial fistula in a chronic pancreatitis patient is presented. This unusual complication highlights a potentially fatal condition requiring prompt recognition and management.

Area of Science:

  • Gastroenterology
  • Cardiology
  • Infectious Diseases

Background:

  • Chronic pancreatitis can lead to various complications.
  • Purulent pericarditis is a rare but severe condition with high mortality.
  • Pancreatic fistulas are uncommon but serious sequelae of pancreatic disease.

Purpose of the Study:

  • To report the first documented case of pancreatico-pericardial fistulization.
  • To describe the clinical presentation and diagnostic findings of this rare entity.
  • To emphasize the importance of considering unusual causes of purulent pericarditis.

Main Methods:

  • Case report of a 54-year-old male with chronic pancreatitis.
  • Computed tomography (CT) scans to identify subdiaphragmatic fluid collection and pericardial fistulization.
  • Analysis of pericardial fluid cultures.

Main Results:

  • The patient presented with dyspnea.
  • CT revealed a subdiaphragmatic fluid collection with a fistula to the pericardium.
  • Pericardial fluid cultures were polymicrobial.

Conclusions:

  • Pancreatico-pericardial fistulization is a previously undocumented cause of purulent pericarditis.
  • This case highlights a rare but life-threatening complication of chronic pancreatitis.
  • Early diagnosis and intervention are crucial for managing purulent pericarditis from any cause.
Keywords:
computed tomographyimagingpancreatic pseudocystpancreatitispericardial effusionpericarditistamponadethoracic

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